ACL reconstruction in the 30+ athlete
Good news! Studies have shown that all grafts in your population do equally well in the long term studies. There are some short term differences in the graft selection, but no “wrong” choice.
Do you make your living playing sports (pro, semi pro, etc)?
Yes- Patella tendon autograft No- Any of the 3
[one_third last=”no”] Hamstring:
Pros
- Strong graft material
- It is your own tissue
- Small surgical scars
- Proven track record and reliability
Cons
- 9 month incorporation time
- Graft fixation is weakest link
- Tendon to bone healing
- Graft harvest pain [/one_third]
Pros
- Strong graft tissue
- Bone to bone healing and strong fixation
- Fastest return to play (6 months)
- It is your own tissue
- Proven track record and reliability
Cons
- Possibility of patella fracture
- Up to 10% of patients will have chronic pain in the knee cap especially with kneeling or deep knee bends
- Largest of surgical scars
- Graft harvest pain [/one_third]
Pros:
- No graft site harvest pain
- Fastest immediate recovery
- Shortest surgery
- Smallest scars
Cons:
- Theoretic risk of infection from donor estimated at less than 1 in a million and no documented cases to date in ACL reconstruction
- Longest return to play (9 months to 1 year) [/one_third]